Lopressor vs. Ziac for Hypertension: Important Differences and Potential Risks.

Key takeaways

Metoprolol tartrate (Lopressor) and Ziac (bisoprolol/hydrochlorothiazide) are both medications used to manage high blood pressure, but they have some key differences. Metoprolol tartrate is a selective beta blocker that is also used to treat chest pain (angina) and to lower the risk of death after a heart attack. It is typically taken twice daily with food. On the other hand, Ziac is a combination of a beta blocker (bisoprolol) and a diuretic (hydrochlorothiazide), which makes you urinate more to help lower blood pressure. Ziac is usually taken once daily and can be taken with or without food. While both medications can cause dizziness and tiredness, Ziac may also make you urinate more often and can cause your skin to be more sensitive to the sun. Additionally, Ziac is not recommended for people with certain breathing problems, whereas metoprolol tartrate is less likely to cause breathing issues compared to other beta blockers. Both medications are available in generic forms, making them more affordable options.

Metoprolol tartrate

(Lopressor)

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Ziac

(bisoprolol / hydrochlorothiazide)

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Summary for Lopressor

Prescription only

Metoprolol tartrate (Lopressor) is a beta blocker used to treat chest pain and high blood pressure in adults. It can also lower the risk of death after a heart attack. You take it by mouth, typically once or twice a day, but your dose depends on your condition. Side effects include dizziness, shortness of breath, and it can make you tired.

Indications for Lopressor

High blood pressure
Chest pain (angina)
Lower risk of death after a heart attack

Pros and Cons for Lopressor

Pros

Fast-acting — works quickly after you take it
First choice treatment after a heart attack
Available in different strengths, so your dose can be adjusted easily
Possible option for those who are breastfeeding

Cons

Need to take with food
Typically need to take more than once a day
Not a first-choice treatment for high blood pressure, unless you have certain heart conditions
Can hide symptoms of low blood sugar

Common Side Effects for Lopressor

Tiredness (10%)
Dizziness (10%)
Diarrhea (5%)
Rash (5%)
Depression (5%)

Warnings for Lopressor

Risks of stopping treatment suddenly
Worsening heart failure
Risk of difficulty breathing
Major surgery
Hiding symptoms of low blood sugar
Hiding symptoms of overactive thyroid
Severe allergic reactions

Summary for Ziac

Prescription only

Ziac, the brand name for bisoprolol/hydrochlorothiazide or bisoprolol/HCTZ, is a combination medication. It's used to treat high blood pressure in adults. It contains two classes of medications: a beta blocker (bisoprolol) and a diuretic (hydrochlorothiazide). It comes as a tablet that's taken by mouth once a day. Some side effects include dizziness and tiredness.

Indications for Ziac

High blood pressure

Pros and Cons for Ziac

Pros

Only taken once daily
Combines two blood pressure medications into one tablet
Can take with or without food

Cons

Comes in fixed dosage strengths, so it's harder to adjust the doses of the individual ingredients
Can make you urinate more often
Not a good option for people with a sulfa allergy

Common Side Effects for Ziac

Dizziness (5%)
Tiredness (5%)
Headache (5%)
Diarrhea (4%)

Warnings for Ziac

Risk of heart problems after stopping Ziac (bisoprolol / hydrochlorothiazide) suddenly
Risk of heart failure
Changes in fluids and electrolytes in the body
Hidden symptoms of low blood sugar
Hidden symptoms of overactive thyroid
Caution use in people with breathing problems
Caution use in people with peripheral artery disease (PAD)
Risk of vision problems and glaucoma